Question:

What is the incidence of Atrial fibrillation (AF) in children under 15. Can AF be familial?

6 March 2009

We have been unable to find any specific data on the incidence of AF in children under the age of 15. The Royal College of Physicians published guidance for the management of AF in primary and secondary care (1) in which they state:

“Conversely, AF is very uncommon in infants and children, unless concomitant structural or congenital heart disease is present.”

A 2004 Canadian Cardiovascular Society conference paper on AF (2)reports:

“AF is rarely seen in the pediatric patient without congenital heart disease, and the largest series, published nearly 30 years ago, was able to identify only 35 cases over a 22-year period. Other pediatric studies have combined AF and atrial flutter, making it difficult to ascertain the frequency of fibrillation in many conditions.”

We have provided a link to the abstract of the above review by Radford & Izukawain the reference section below. (3)

A 2006 guideline published by ACC/AHA/ESC  (4) contains a section on familial AF . We have reproduced this below:

“Familial (genetic) atrial fibrillation
Familial AF, defined as lone AF running in a family, is more common than previously recognized but should be distinguished from AF secondary to other genetic diseases like familial cardiomyopathies. The likelihood of developing AF is increased among those whose parents had AF, suggesting a familial susceptibility to the arrhythmia, but the mechanisms associated with transmission are not necessarily electrical, because the relationship has also been seen in patients who have a family history of hypertension, diabetes, or HF. The molecular defects responsible for familial AF are largely unknown. Specific chromosomal loci have been linked to AF in some families, suggesting distinct genetic mutations. Two mutations associated with gain of function leading to short atrial refractoriness have been discovered in several Chinese families.”

The guidance from the Royal College of Physicians (1) notes:

“Those with a family history of AF (familial AF) may require specialist assessment.”

1. http://www.rcplondon.ac.uk/pubs/contents/d74e2562-519e-46b4-b952-48433c6076b7.pdf
2.http://www.ccs.ca/download/consensus_conference/consensus_conference_archives/2004_Atrial_Fib_full.pdf
3. http://pediatrics.aappublications.org/cgi/content/abstract/59/2/250
4. http://www.escardio.org/guidelines-surveys/esc-guidelines/GuidelinesDocuments/guidelines-afib-FT.pdf

Help us improve this answer:

  • TRIP will review each comment and will only publish those we feel will enhance a particular answer. As a result of the review process there will be a delay between submission and publication of accepted comments.

Email this question to a friend:

DISCLAIMER: TRIPanswers is a collection of clinical questions and answers. Each provider will have their own methodology in answering questions and these are likely not to be as rigorous as systematic review.  If you have any doubt as to the implications of this contact the Q&A Service Provider for further information. This document is presented for information purposes only. This document cannot and should not be used as a basis of diagnosis or choice of treatment, and is in no way intended to replace professional medical care or attention by a qualified practitioner. TRIPanswers and TRIP Database Ltd are not responsible or liable for, directly or indirectly, ANY form of damage whatsoever resulting from the use/misuse of information contained in or implied by this document.  Also, ensure you have read the terms and conditions for using the site.

print Print this answer
Advertisement